Home Care Fraud - How to escape.

[erroridiot]

I have never reported an agency to the authorities for fraud, but I have been accused of doing so and have been blacklisted.

I have seen so much horrifying fraud in home health care that I don't want to work in this field any longer. Sad to say, home care turns my stomach. Part of the problem is the amount of QA I have done at a lot of agencies, usually agencies in some kind of trouble. I see it all and it irks me to the point that I can no longer look at it.

I can't seem to escape home care at all as no employer will give me a chance to do something different. Nursing jobs are scarce in this area. I attended an orientation for a contingent position this week with nurses who had driven 1-2 hours or longer to get to the office. Of course, if was just another agency signing up lots of new staff and having very little work to offer anyone.

Any discussion about getting out of home care, handling fraud and handling blacklisting would be appreciated.

[Numinous1]

I am a HH supervisory nurse and feel frustrated that taxpayers are footing the bill for Mothers to give their children baths. I voiced my concern and was told that it is all up to the Social Worker/Case Manager.

[Numinous1]

So is it fraud if the client has an able and competent parent in providing their care who is home all day chatting up the nurse and they are recieving 40hr per week in home care for thier child. Plus respite hours. if they are home all day,then why should the taxpayers be paying for this. would love to know of your experiences and your thoughts on the matter.Blissmissrn

I am a HH supervisory nurse and feel frustrated that taxpayers are footing the bill for Mothers to give their children baths. I voiced my concern and was told that it is all up to the Social Worker/Case Manager. I am not comfortable with this....any ideas?

[carwin]

First learn the regulations of that particular program. The Medicaid waiver programs can sometimes offer a lot. MSWs also have great resource knowledge and can often string together several programs to provide a large chunk of time for people. No offense to my fellow nurses but that is why I encourage using MSWs. While nurses focus on the medical, I think MSWs really understand the psychology behind caring for the chronically ill. I am in skilled care. The fraud is ridiculous

Now if you want to be concerned about something skilled care in HH can be so dirty. There are people who sit in front of their TV's and literally make up visit notes (generating $1000-2000 paychecks) after having the patient sign several blanks at one time, or for marketers who toss the same patients from agency to agency or non homebound patients who sell their medicare numbers and signatures. The crazy thing is that a lot of this money that is being stolen from medicare is not even staying in this country.

If a mom is entitled to the care so be it. I surely wouldn't want to trade places with her. But someone intentionally stealing from the government and buying luxury boats and cars, great trips, vacation homes, private schools makes me nuts.

[MindyTX]

Thank you for your courage in reporting fraud. We should never be indifferent to fraud and keep quite. Guess what kids, this is your and my money and our future healthcare insurance when we are elderly. Even if it is the agency that pays us and can make our life difficult for a short while, the long term effects are devstating to Medicare viability. Without knowing your exact circumstances I still think home health is an option for you. Any ethical comapny with an active compliance plan and compliance officer would be grateful to have an employee like you. At the next interview ask if the company has a compliance plan and officer and how frequently staff training occurs. Good luck to you. You appear to be the kind of nurse who needs to stay in home care, ethical, professional and beyond reproach and we need a lot more like you.

[carwin]

You must report or may be considered a part of the crime.

[Luv2care0907]

My agency does not do any of that and neither do I. I am at my job the time I say I'm there. In fact, in my orientation, the case managers made a big deal about being at the job the entire time that I am supposed to be. Has anyone gone electronic yet in home care? Just curious.

[carwin]

Yes, currently in an electronic environment and love it. QA can read the notes!!